Drinking alcohol has more risks than people realize, says Thomas Frieden, director of the federal Centers for Disease Control and Prevention. / Nikada iStockphoto

by Kim Painter, Special for USA TODAY

by Kim Painter, Special for USA TODAY

Most adults, including binge drinkers and pregnant women, say they have never been asked about their drinking by a doctor or other health professional, new survey data show.

It's time for that to change, say officials with the federal Centers for Disease Control and Prevention, who released the data Tuesday.

"Drinking alcohol has a lot more risks than many people realize," says CDC Director Thomas Frieden, who spoke during a telephone press conference. "In the same way we screen patients for high cholesterol and high blood pressure, we should be screening for excess alcohol use and responding effectively."

The new report is based on a survey of 166,753 adults over age 18 from 44 states and the District of Columbia. It was conducted in 2011. It found that just one in six adults said a health professional had ever discussed drinking with them. Among those who admitted to binge drinking - having more than four drinks at a time for men or more than three drinks at a time for women - the rate was a bit higher, but still just one in four. Just 17% of women who were pregnant at the time of the survey said they had ever been asked about drinking, even though most health authorities advise against any drinking during pregnancy.

Since 2004, the influential U.S. Preventive Services Task Force has recommended that health professionals ask adults about their drinking habits. The Affordable Care Act says new insurance policies should cover such screening. The idea is not only to find people with alcoholism, but to find and offer brief counseling to those whose problem drinking may not rise to the level of addiction.

"For every one person who has alcoholism, there are at least six who are problem drinkers," Frieden says. They face health and safety consequences, including increased risks of breast cancer, sexually transmitted diseases, unintended pregnancies, fetal alcohol disorders, vehicle crashes, violence and suicide, according to the CDC.

Studies show that asking patients about their drinking and then offering brief counseling to those who drink too much can reduce problem drinking, the agency says.

"We are not saying no one should drink. Most people who drink do so without adverse health effects," Frieden says. "But many people who do drink drink too much at a time or too much overall... The health system is not doing a good job of finding out about these problems."

Why not? "We know doctors' offices are busy," Frieden says, and some doctors may bring up drinking only with patients they think are at high risk. Many also may feel they won't have time to follow up if they find problems, he says.

Making alcohol screening and brief counseling part of routine care will mean setting up health systems so that doctors, nurses, social workers and others can work together and use the latest technology, including electronic screening and counseling tools, he says. Some systems, including Kaiser Permanente Northern California, are already doing that, he says.

Part of the problem is that substance abuse is "still too often framed as a justice problem or a moral problem rather than a medical problem," says Susan Foster, vice president and director of policy research at the non-profit addiction research and advocacy group CASAColumbia, New York.

The health care system should be doing more to find and help people with all sorts of substance abuse problems, at all stages, she says.

"Alcohol is the most frequently used addictive substance, but it's not the only one," she says. "We really need to be screening for all risky use. â?¦ It's just common sense."